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Can diabetes affect my pregnancy?

Q: I have diabetes. Is there anything I should know before I get pregnant?

A: Preconception and prenatal care are crucial for women with diabetes to have healthy pregnancies and babies.

First, it's important to have your blood sugar levels in check before you get pregnant, since excess sugar in the bloodstream can cause birth defects and miscarriage early in pregnancy. Once you become pregnant, you should see a high-risk obstetrician experienced in caring for women with diabetes, who'll monitor you closely to make sure your blood sugar levels remain steady.

If you have type 1 diabetes, you may also want to see a nutritionist or diabetes educator (someone specially trained to teach diabetics how to live with their disease) in addition to your ob-gyn to help manage your condition. Because your blood sugar issues may change throughout pregnancy, it's important to keep records of your diet, exercise, and insulin regimen, and to check your blood sugar as often as your doctor advises.

If you have type 2 diabetes you'll also need special attention, especially if you're on medication to control it. Many diabetes pills are safe to take during pregnancy (especially since the benefit of controlling the condition well outweighs the risks). If your doctor is concerned about the particular type of medication you're taking, he or she may suggest that you switch to insulin injections instead. And you should know that many pregnant women with type 2 diabetes are able to keep blood sugar levels in check through diet changes (avoiding foods like sugary snacks and bread or pasta) and exercise, without needing medication. --Stephanie Hunt